THE COMMUNITY SOCIAL AND HEALTH-CARE SYSTEM IN FINLAND

The greatest challenge to the national social and health policy in Finland since 1992 has been the task of finding a correct cost/quality ratio of required services. The local authorities have the responsibility to arrange the services to the citizens and may purchase the service from a municipal or a private sector provider. The State supervises the field and contributes to the finding, but the local authorities are responsible for organizing the health services. The central bodies are the Ministry of Social Affairs and Health, and the National Research and Development Centre for Welfare and Health which operates under supervision of the Ministry. Introduction into practice of the population responsibility principle has been started. A patient applies first to his local health centre or private practitioner for examination and treatment, If he cannot be treated there, he is referred to the outpatient department of a hospital. The aim is to ensure continuity in staff-patient contacts. Health care and social care is a natural right of every citizen. The national plan for social and health services is based on statistical data. The entire population is covered by sickness insurance, which includes compensation for lost earnings and treatment costs. Sickness insurance is run by the Social Insurance Institution, directly subordinate to the Parliament and also administering the flat-rate pensions. The Institution has its own network of district and local offices. The Act on the Status and the Rights of a Patient is a comprehensive Act covering the fields of admission, treatments, patient's autonomy, access to information, report on patients, and confidentiality. According to this legislation the Ministry of Social Affairs and Health has the right to give statements about the patient documentation and saving. Since 1980-85 information systems of patient administration have been in common use in the hospitals, the municipal social and health services, and the private sector. The electronic health care record has been used by about a fifth of the municipal health centres. Hospitals have been slower to get into use the electronic patient records. Private sector and the Social Insurance Institute have acquired experience in the use of patient cards. The social and health care sectors have altogether about 20 different large-scale information systems in use.